Florida's Medicaid overhaul on fast track to managed care

TALLAHASSEE — Advocates for the disabled, elderly, hospitals and other interests objected to some details and the timing of a massive Medicaid overhaul Monday, but the plan won near unanimous approval at its first — and possibly last — committee hearing in the Florida House.

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The measures would carry out a plan to expand a five-county pilot program of managed care by private companies or other groups, including provider service networks made up of doctors and hospitals, to all of Florida's 67 counties over the next five years.

The state would be divided into six geographic sectors. Managed care providers would compete for a maximum of three to 10 contracts in area.

Lawmakers see the plan as a way to rein in the growing cost of the fraud-plagued state-federal program that provides health care for 2.7 million low-income and disabled Floridians. The program is expected to consume $19 billion in the next fiscal year and account for more than a quarter of the state budget.

There was plenty of discomfort about the bills that are on a fast track after getting a late start. House leaders waited until last week to unveil the plan, and now just 18 days remain in the session.

The Senate already has passed its own Medicaid overhaul that would add only 19 counties to the experimental program launched by then-Gov. Jeb Bush.

Alisa Snow of the Florida Community Health Action Information Network, which advocates for Medicaid patients, urged lawmakers to delay action for a year to get a complete analysis of the pilot program and assess how the new federal health care overhaul would affect it.

Rep. Gary Aubuchon, though, said there's no need to wait. "There are pieces and parts that people are unhappy with, but I would submit to you if we studied this for the next 10 years and then brought a bill forward there would be pieces and parts that people were unhappy with," said the Cape Coral Republican.

Most state Medicaid programs use managed care in varying degrees, but Kingsley Ross of the Autism Society of Florida told the panel the House legislation would make Florida the first to turn to for-profit health maintenance organizations to provide programs for developmentally disabled people.